By the age of seven, ‘a teacher’ had become one of my regular answers to the question, ‘what do you want to be when you grow up?’ It was also the age I was diagnosed with type one diabetes.
Through my years at school, college and university, my answer to that question changed, or became unclear and at times unknown. But, following my final exam in my final year of university whilst I sat waiting for my friends to join me in the pub, I decided I was going to pursue the career path that the seven-year-old me had aspired to and that had been the job that I’d repeatedly returned to over the years, teaching. Or more specifically, a secondary history teacher.
I was going to try to make a comparison between my journey to deciding to become a teacher and my journey with diabetes, but the truth is if I did that it would be a misrepresentation of what it is like growing up as a type one diabetic. It’s not a condition that you only deal with when ‘it’s bad’ or, that you just take a tablet for in the morning and then go about your day. It is a condition that is present every minute of every day from the moment you are diagnosed.
Type one diabetes is an autoimmune disease, caused when the cells in your body attack your pancreas meaning it can no longer produce the hormone insulin, which regulates your blood sugar by breaking down the carbohydrates in food and drink turning them into glucose, which is essential for the fuelling and functioning of the body. Diabetics monitor their blood sugar levels through either finger pricks or, like me, via a continuous glucose monitor (CGM).
We also must self-administer insulin either through regular injections, the amount of which is calculated based on the amount of carbohydrates in food and drink and by what our blood sugar levels are doing, or through an insulin pump which is what I also use. Additionally, diabetes can be impacted by anything and everything, which makes monitoring and controlling the disease even more challenging.
The impact and role that diabetes has played during my teacher training is best encapsulated by this experience on my first day, on my first placement. Following a morning of learning safeguarding procedures, behaviour management policies, the school layout and how the school ran day-to-day, along with trying to remember a whole new group of people’s first and last names, I was ready to spend the afternoon sat at the back of a classroom observing.
I was in a year 11 lesson, we were about ten minutes in, when a high-pitch, loud repetitive beeping started and suddenly 31 pairs of eyes were all staring at me, quickly followed by an outburst of excitable whisper with the students’ making comments like, “That’s her phone, how embarrassing!” I quietly went and apologised to the teacher and explained that it was my insulin pump, alerting me that my blood sugars were high. This situation demonstrated to me how diabetes was going to be an ever and at times an undeniable presence in my teaching.
At the start of training, one of the first big challenges I had to overcome was adapting to a new routine. Like most people, when your routine changes it can be a bit of a shock to the system, but the worst most people feel is extra hungry or tired. For a type one diabetic, a change to routine can cause both of those things which then cause your blood sugars to either soar or plummet, making adapting to a new routine that much more challenging, as you try to figure out how to adapt your diabetic care to fit into the new routine.
My advice for anyone who becomes a mentor to a type one diabetic is to be mindful that the first week of them being in your school is going to be even more exhausting and overwhelming than for your standard trainee. As well as trying to absorb and learn all the information you are throwing at them, they are also going to be feeling like their body is going through nine rounds with Anthony Joshua.
Similarly, if you are a trainee, my advice to you is to be honest with your mentor about how training is impacting your diabetes as your health and wellbeing are just as important as being in the classroom and completing all your assignments. You will be working in an environment where you are exposed to so many different germs and illnesses, that you will inevitably become ill, and taking a couple of days out can be so much more beneficial to you and your teaching than soldiering on through.
What is probably the most obvious indicator and sign that someone is a type one diabetic are high (hyperglycemia) and low (hypoglycemia) blood sugars. This is also, or it has been for me, the most obvious sign to the students that I am a diabetic. Especially when my CGM and pump are alarming or I am swigging from a bottle of Lucozade whilst teaching. But what people who are not type one diabetics understand is the physical feeling of having these lows and highs.
When your blood sugars are high, it is like a thirst you have never experienced before, that you can’t quench accompanied with a pounding thumping headache that causes your whole body to ache and all you want to do is curl up in a dark room and drink a bathtub’s worth of water. Likewise, when your blood sugars are low, your body feels like you’re not in control anymore, you’re flooded with a shaking, pulsating feeling and your head feels like it’s underwater. You are unable to process what is going on around you and your brain becomes foggy, thoughts becoming jumbled or disappearing completing and your heart starts racing, and the only response your body can process is the urgency to get sugar inside of you. Imagine having either of these happen to you whilst you’re stood in front of a class, it is a terrifying feeling as you try to push on through.
For trainees, make sure you always have supplies on you. I always have a packet of GlucoTabs in my pencil case and a bottle of water, along with checking my blood sugars before I teach a lesson to try to pre-empt and prevent a low or a high from happening, but as we all know that isn’t always possible. Talk to your mentor about what you want to do if you have a high or low during a lesson. It might just be that you want to carry on, get the students onto a task and then take a couple of minutes to sort yourself out. Or it might be that you want to come up with a signal or sign that your mentor knows to look out for, that if you do feel the need to leave the classroom to sort yourself out then you can, and you’ve got the reassurance that everyone is aware of why and what is going on.
I’m sure many people reading this article know too well (or if you’re about to embark on teacher training, you will soon discover), that when you’re training your mind is constantly trying to remember everything all the time. A fellow trainee and I sat down and came up with a list of all the things we have to try to remember to do on a standard day on placement, and within a couple of minutes our list exceeded 20. We then did the same for all the ‘day-to-day’ things you have to remember, like washing, food shopping, replying to a text, and again within a couple of minutes our list exceed ten. Then finally, I composed a list of all the diabetic-related things that you’re continuously thinking about; injecting, changing CGM and cannula, predicting how your blood sugars are going to react, and again within a few minutes I had a list of almost 20. Purpose being to highlight, again, how constant managing type one diabetes is, on top of everything you are trying to learn and remember when training and around normal life stuff. Meaning at times, everything can just feel incredibly overwhelming and tiring.
The best strategies I’ve found to help feel like your head isn’t about to explode are, at the beginning of the week or in the morning, doing a physical brain dump, writing down everything you need to do and want to achieve that week or day, then breaking that down into manageable and achievable to-do lists for each day. Also utilising the reminders app on your phone, programming in when you need to order more supplies, when you need to arrange to get blood tests done, when you need to change your cannula and insulin vials. I found it just helped to take some of the pressure off trying to remember and keep track of those little diabetic survival jobs. Mentors, my advice would be just to have a level of understanding and leniency that there may be times when trainees need added support or an extra day to complete a lesson plan, or just somebody to verbalise everything that is swarming around in their head.
The final point that I want to make about is misconceptions, as hinted at when the students accused me of having my phone on in class. Misconceptions about type one diabetes and diabetes, in general, are ever present in society and largely go unchallenged. I’m not expecting 15 and 16 year olds to know what a pump alarm sounds like, but our awareness and understanding of diabetes does need to change. Several times whilst I have been training people have made comments like, “you don’t look like a diabetic.” or “I better not offer you a biscuit!” Although they don’t appear to be damaging, they do show how widespread and embedded some misconceptions are.
Two of the most damaging misconceptions out there are, it isn’t a ‘real’ disability: just because it isn’t a visible disability doesn’t diminish the fact that is a disability. That needs to be respected and honoured in the same way someone with a visible disability is. Second misconception, that type one diabetes affects people all in the same way. Despite the fact everyone becomes a type one diabetic in the same way, the impact and the way it affects someone is individual to that person and is ever evolving and changing. As has become my running theme with advice throughout this article, mentors should chat with their trainee and understand how their diabetes impacts them. Equally, trainees you need to communicate and be honest about how their diabetes impacts you and don’t take the view that it doesn’t matter, that you can deal with it on your own or, that you don’t want to come across as being problematic or needy. Because at the end of the day, mentors are there to support and guide you, and understanding and getting to know you is a fundamental part of that.
Hopefully this article hasn’t put any type ones off teacher training or any mentors off mentoring type one diabetics, but it was important to me to be honest and offer meaningful advice.
I want to finish this blog with this: I am proud of the teacher I am becoming, but I am even prouder to be a teacher who is diabetic. Through this experience I have witnessed how impactful being open and honest about your own adversities can be to students. About a week later, I went back into that year 11 class and some of the students asked me about the beeping and I explained to them that I was a type one diabetic, and it was my insulin pump that was beeping. This then led to further questions and a discussion about diabetes with them thanking me for talking to them about it and that it was cool to see someone like me becoming a teacher.
Over time I realised that the ‘someone like me’ comment meant someone who had something ‘different’ about them, who didn’t fit into the idealistic model students have constructed about teachers. The phrase “see it to believe it” encompasses how important it is for students to see people who face challenges succeeding and achieving their goals and dreams. There have been multiple times through training that I have had conversations with students who face their own daily challenges whether that Autism, Tourette’s syndrome or Dyslexia and been able to find similarities between what they’re facing and what I am or have had to face. This has enabled me to help and offer empathy to them from a perspective they haven’t had before, as well as demonstrate to them that they can achieve whatever they set their mind to. It just might just be that bit tougher and take that little bit longer but they can and will achieve it.
In September when I start my job, I probably won’t be walking around on the first day wearing a sandwich board that reads ‘I am a diabetic teacher’, but it is not something I am going to hide from the students or, avoid talking to them about, it is something I am going to celebrate. Therefore, I would strongly encourage any diabetics or anyone else with a disability to sign up and become a teacher because you never know what difference you might make to a student by simply being you.
Anya Renouf is a trainee teacher at Bournemouth Poole and Dorset Teacher Training Partnership.